Milly is suffering.. are we being cruel

[Milly]

Our little Bichon is eight tears old. Eighteen months ago she was diagnosed with Cushings. Eventually this was managed and she has 5 mg of Trilostane per day. When the steroids started to be reduced in her body she started with arthritis especially in her front leg. She found it painful to walk. Last November she had a cruciate ligament operation which made her very ill, we nearly lost her.She had a severe attack of Pancreatitis.She was then diagnosed with diabetes. She also has a liver problem. It is now nearly April and our little dog has still not recovered from the cruciate ligament operation and can hardly walk comfortably. She doesn't enjoy her walks anymore.
Her diabetes is proving very difficult to control despite a strict feeding routine and twice a day insulin injections.She is still véry ill and life is hard for her, She sleeps most of the time and finds it difficult to play because of her injury and painful arthritic front leg.As her Diabetes is still not regulated she is panting more often than not and she drinks a lot of water.She has moments where she tries to play but it doesn't last long. She can still be perky especially when we have visitors and she enjoys her food.She visits the vets every week at the moment and he keeps her in for the day whilst he does a glucose curve and observes her.
She is on 15 units of insulin twice a day and weighs 6.5 kg.
She hasn't really improved much since Christmas.Are we being cruel in keeping her alive to suffer like this? We keep wishing for a miracle, but is it a miracle that is never going to happen? We just want her to be happy again.

[Judi]

Re: Milly is suffering.. are we being cruel

Tami, a poster on here had posted that they figured as long as they could name 3 things their dog enjoyed, they wouldn't make the tough decision.

We tried to use that as a guideline for our Jenny's final months as well.

Like Milly, Jenny enjoyed some things in her final months but she slept a lot.

After we let her go, and I was remembering my sassy, perky girl vs. the tired old doggy she was the last couple of months, I understood why almost everyone in our lives had kept telling me I was holding on too long.

We fight so hard to get them through these illnesses, it's hard to stop.

I think you are going through the thought process in the right way. You don't want her in pain or miserable.

hugs to you and a belly rub to your Milly. Judi

[LizE]

Re: Milly is suffering.. are we being cruel

I'm so sorry your family is going through this. You know Milly best and your intuition is your best guide.

I have a senior pet who tore her doggy acl when she was 9. We opted not to do surgery but I can tell you even with surgery that it is a very long recovery time. The only dogs I know that had very good recovery from the surgery did physical therapy. There is a shocking amount of muscle atrophy from the injury. In Snickers' case we had access to water and had her swim.

While she was healing we purchased a dog stroller for her so she could still go on "walks". We would push he to a location, let her get out and sniff around or meet other dogs. It was a godsend - she was pretty depressed when she couldn't get around but the stroller gave her a new lease on life.

It seems once she got older that mental stimulation was more important than physical play. I try to get her to see another dog every day even if its for just a few moments. The one good thing about sleeping so much is that it doesn't take a lot of activity to keep her happy.

My dog has also lost her hearing and vision so she can no longer run around and play and she sleeps all day. She is no longer that puppy that runs around and chases squirrels but she is still a great dog. We have just adjusted to the new reality.

I really don't know your exact situation but since she is still eating and likes visitors she might be tolerating her condition better than you think. Have you tried giving her anything for the pain? With liver issues she not a good candidate for rimadyl but have you tried tramadol? A collagen supplement for dogs could might help too but that takes a while to be effective.

In the short term would suggest giving your dog massages, both for her back and her legs. At the very least it is some quality time with your pet.

You have a difficult situation but you seem like the kind of person who will make the best decision you can. Thought and prayers to you.

[jesse girl]

Re: Milly is suffering.. are we being cruel

my jesse was very sick when this journey began . what i did was take her on car rides stacked some pillows on the seat so she could see out the window and drove to places where she could see some rabbits maybe squirrels or kitty's

she struggled with walks and was a bit dangerous because her blood sugar would drop very fast when walking

maybe if you could get blood sugar in a better range she might be more happy and perky and the good thing you have some control over that .i would recommend testing blood sugar at home and see if you can improve it

its going to be more challenging with the other problems but not impossible the problem is the vet is not going to put in the time that is needed so you would have to take on most of the heavy lifting

give yourself say 3 months if blood sugar is better and milly feels better ( its never going to be the way it was and thats ok ) the reevaluate from there it took my jesse 6 months to get off deaths door and almost a year to be normal again now she was a younger dog at 5.5 years old

if you need help with testing just ask or look up the info tons of it out there . we can help you understand what the numbers might mean and a direction to go on dosing

[MikeMurphy]

Re: Milly is suffering.. are we being cruel

Sorry you are going through all these problems.

Maybe there is still hope in making her life more comfortable, if you can get her blood glucose under control. 15 units is a lot of insulin for 6.5kg (14lb) dog.

Can you post the latest curve that your vet has done? Then we could see if maybe we have gone beyond the proper dose.

[Milly]

Re: Milly is suffering.. are we being cruel

Thank you for your help and concerns.Milly is on 32 units of insulin a day.,This appears a lot for a little dog but her diabetes isn't under control yet.I havn't got a printout of her glucose results but I do remember the lowest was 12 and the highest 27.That was two days ago.
She has been on Tramadol but it didn't appear to help at all.
She has chicken and white rice for breakfast( should it be brown?), carrots, beans and water melon at lunchtime and Royal Canin Gastrointestinal with a tiny bit of chicken in the evening.
As I'm writing this she is fast asleep on her cool mat. A few minutes ago she hobbled to me as she saw I was having a biscuit with my cup of tea.
It's not easy to find three things she enjoys.
1 She enjoys her food
2 She enjoys being with us and others. She just makes sure we are there then goes back to sleep.
3 .........

So sad.

[MikeMurphy]

Re: Milly is suffering.. are we being cruel

Thank you for your help and concerns.Milly is on 32 units of insulin a day.,This appears a lot for a little dog but her diabetes isn't under control yet.I havn't got a printout of her glucose results but I do remember the lowest was 12 and the highest 27.That was two days ago.
She has been on Tramadol but it didn't appear to help at all.
She has chicken and white rice for breakfast( should it be brown?), carrots, beans and water melon at lunchtime and Royal Canin Gastrointestinal with a tiny bit of chicken in the evening.
As I'm writing this she is fast asleep on her cool mat. A few minutes ago she hobbled to me as she saw I was having a biscuit with my cup of tea.
It's not easy to find three things she enjoys.
1 She enjoys her food
2 She enjoys being with us and others. She just makes sure we are there then goes back to sleep.
3 .........

So sad.

Thanks for the info.

That's a pretty big swing in blood glucose from 27 (486 US) to 12 (216 US). Maybe you could ask your vet for the complete curve printout. The 12 reading shows that the insulin is indeed working and there is no resistance from the Cushings. The full 12 hour curve would be helpful. Big swings can be caused by several things such as too much insulin or improper interaction of food and insulin.

It's important to be consistent with meals... feed the same diet every 12 hours. Chicken and rice in the morning and Royal Canin at night may be the problem. It's best to feed the same thing am and pm.

[Judi]

Re: Milly is suffering.. are we being cruel

I do know that others on the cushings forum have said that as cortisol levels go down, aches and pains hurt more My Jenny was on tramadol her last couple of months, that contributed to the sleeping

I agree if you could keep her blood sugar down she'd probably feel better

does she enjoy being outside?

[Lchow022]

Re: Milly is suffering.. are we being cruel

Hang in there!

Stay positive for Milly as they can sense our stress and sadness..
I went through hell and back last year when my Mochi was diagnosed too. I made a mistake by changing his diet to raw pork right away and caused even more problems then just high blood sugar. He ended up having major pancreatitis and uti..couldn't eat..couldn't sleep..kept throwing up..I rushed him to the vet back and forth everyday. He would look better at night and eat a bit..and then the next day he wouldn't eat again. His pancreatitis was so swollen it ended up affecting his liver and caused liver problems..It was 3 weeks of going to the vet every day back and forth. I almost gave up when both of his blood tests came back super bad..Then after a month of suffering things started to turn around. He seemed a lot better and was eating again. His blood sugar finally under control and he was playing. We had to continue injecting iv in him for another month to clean out everything.

Don't give up just yet...I know how painful it is seeing your pet in pain and suffering. But if Milly is still happy when you guys are around that means she's not ready to let go. I agree with Jesse girl. Give it a few months..and take it a step at a time.

Take care

[Milly]

Re: Milly is suffering.. are we being cruel

We are going back to giving her Royal Canin morning and night with a little chicken.We started the chicken and rice as sometines she turns her nose up at Royal Canin in the morning.She enjoys her lunchbowl of veg and fruit.
We are hoping when her diabetes is under control she will feel happier. I keep massaging her operated leg and her front leg.These hinder her mobility a lot at the moment.
Yes she does like being outside even though she won't walk. I am so glad the summer is ahead of us.
We are hoping all the time she will improve, we have to keep positive.

[amydunn19]

Re: Milly is suffering.. are we being cruel

I used the Quality of Life Scale quite often during the last few months of Maggie's life:

http://aplb.org/resources/quality-of-life_scale.php/

[Milly]

Re: Milly is suffering.. are we being cruel

We have been back again today to the vet. Her curve is improving but her insulin has been increasd again to 17 units twice a day.
She is only a small Bichon weighing fifteen pounds so this is a lot for her. Her Cushings is not helping her glucose levels.
She is also struggling to walk at times. I feel so sorry for her.

[jesse girl]

Re: Milly is suffering.. are we being cruel

thats allot of insulin and may show the cushings is not that well controlled

the scary part about that if it becomes better controlled the dose of insulin may need to dramatically drop and that can happen at any time

i wasn't sure if your home testing blood sugar if not i would just to keep milly safe from possible low sugar if the cushings becomes better controlled

in the end you probably cant expect good blood sugar but dogs can be very tolerant of higher sugar

well things do seem better from your post thats good and hope they continue to improve

[Milly]

Re: Milly is suffering.. are we being cruel

I do not home test Milly's blood sugars as the vet has her in every week and he does it.
As soon as she is regulated I will ask to start doing it myself. She has the Cushings tests every three months now and that seems to be under control.
Thank you for your help.

[Milly]

Re: Milly is suffering.. are we being cruel

Milly's diabetes is nearly under control. She has stopped drinking all the time and does not pant as much.
Her quality of life is still not good. She struggles to walk as she is in pain after her cuciate ligament operation and her front knee has severe arthritis and she often holds it up as she tries to walk.
When we say'walkies!' she immediately perks up but as soon as she tries to walk she doesn't want to go.
She started hydrotherapy last week hoping this will help. It is heartbreaking to see her as she just lies down on her mat most of the day.
Tonight I have noticed the lens in her eyes are clouding over, we are heartbroken. She is gradually going blind.
After all she had been through we cannot let her be blind as well. She will not survive another operation, The time will soon come when we have to let her go.We cannot imagine life without our beautiful Milly but we cannot let her suffer anymore. We are going up to the Lake District next week in our caravan. She will be with us and we will try our best to make her life as happy and as comfortable as possible. These next few weeks will be precious time spent together.